Prospective Electrocardiogram-Gated Axial 64-Detector Computed Tomographic Angiography vs Retrospective Gated Helical Technique to Assess Coronary Artery Bypass Graft Anastomosis: - Comparison of Image Quality and Patient Radiation Dose -

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ultidetector computed tomographic (CT) coronary angiography is used widely to detect coronary artery disease (CAD) because it is accurate and noninvasive. The novel application of the angiographic view has currently improved the clinical feasibility, especially for explaining disease distribution and severity to the patient and for discussing the treatment strategy in conference. 1-3 Single-center studies have reported 30-95% sensitivity and 86-98% specificity for detecting obstructive CAD using 16-detector CT, compared with conventional coronary angiography (CCA) as the reference modality, and 93-97% sensitivity and 95-99% specificity using 64-detector CT. 4,5 In multicenter studies also, 16-detector CT had 89% sensitivity and 65% specificity for detecting CAD in a segment-based analysis, and in a patient-based analysis, 16-detector CT had 98% sensitivity and 54% specificity and 64-detector CT had 85% sensitivity and 90% specificity. 5,6 Thus, 64-detector CT is superior to 16-detector CT in identifying the presence and severity of obstructive CAD, but it increases the patient's radiation exposure when the retrospective electrocardiogram (ECG)-gated helical technique is used, because the helical pitch is smaller and the tube power is higher. Effective doses reported with 64-detector CT (9.5-21.4 mSv) are higher than those reported in 16-detector CT (3.1-9.4 mSv) studies, as well as those required for CCA. 7 CT examination with an effective dose of 10 mSv may increase cancer deaths by approximately 1 in 2,000 cases.

Prospective versus retrospective ECG-gated 64-detector coronary CT angiography for evaluation of coronary artery bypass graft patency: comparison of image quality, radiation dose and diagnostic accuracy

“…Until now, there are only two studies [15,16] for evaluation of bypass graft by using CCTA with PGTtechnique. Chazen et al [15] suggested PGT technique should be used whenever ventricular functional assessment is not required, and Machida et al [16] reported 64-MDCT with PGT-technique is even superior with RGH-technique in limiting the radiation dose and maintaining the image quality for the assessment of distal anastomosis.…”

“…Chazen et al [15] suggested PGT technique should be used whenever ventricular functional assessment is not required, and Machida et al [16] reported 64-MDCT with PGT-technique is even superior with RGH-technique in limiting the radiation dose and maintaining the image quality for the assessment of distal anastomosis. However, they did not study the diagnostic accuracy of the PGT- Fig.…”

“…However, there are only a few attempts [15,16] regarding the imaging quality of CCTA using the PGT technique for the evaluation of a bypass graft vessel. In addition, to the best of our knowledge, there is no report including the diagnostic accuracy of CCTA with the PGT technique for evaluation of graft in comparison to ICA.…”

Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy

“…Three studies were excluded from the analysis as they either focused on the assessment of coronary stenting or coronary bypass instead of coronary artery disease [38][39][40].…”

Assessment of Coronary Vasoreactivity by Multidetector Computed Tomography - Feasibility Study With Rubidium-82 Cardiac Positron Emission Tomography -

“…18 Our hypothesis was that state-of-the-art MDCT would be able to detect changes in the coronary artery as does quantitative coronary angiography, but in a non-invasive manner with a low radiation burden. Thus, our aim was to verify the feasibility of a non-invasive MDCT technique of assessing endothelial vasomotor function, as compared with MBF quantitation using PET/CT.…”